Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA.
Neurosciences Institute at Intermountain Medical Center, Murray, UT, USA.
J Int Neuropsychol Soc. 2024 Mar;30(3):232-243. doi: 10.1017/S1355617723000528. Epub 2023 Aug 29.
Preclinical Alzheimer disease (AD) has been associated with subtle changes in memory, attention, and spatial navigation abilities. The current study examined whether self- and informant-reported domain-specific cognitive changes are sensitive to AD-associated biomarkers.
Clinically normal adults aged 56-93 and their informants completed the memory, divided attention, and visuospatial abilities (which assesses spatial navigation) subsections of the Everyday Cognition Scale (ECog). Reliability and validity of these subsections were examined using Cronbach's alpha and confirmatory factor analysis. Logistic regression was used to examine the ability of ECog subsections to predict AD-related biomarkers (cerebrospinal fluid (CSF) ptau/Aβ ratio ( = 371) or hippocampal volume ( = 313)). Hierarchical logistic regression was used to examine whether the self-reported subsections continued to predict biomarkers when controlling for depressive symptomatology if available ( = 197). Additionally, logistic regression was used to examine the ability of neuropsychological composites assessing the same or similar cognitive domains as the subsections (memory, executive function, and visuospatial abilities) to predict biomarkers to allow for comparison of the predictive ability of subjective and objective measures.
All subsections demonstrated appropriate reliability and validity. Self-reported memory (with outliers removed) was the only significant predictor of AD biomarker positivity (i.e., CSF ptau/Aβ ratio; = .018) but was not significant when examined in the subsample with depressive symptomatology available ( = .517). Self-reported memory (with outliers removed) was a significant predictor of CSF ptau/Aβ ratio biomarker positivity when the objective memory composite was included in the model.
ECog subsections were not robust predictors of AD biomarker positivity.
临床前阿尔茨海默病（AD）与记忆、注意力和空间导航能力的细微变化有关。本研究旨在探讨自我报告和知情人报告的特定认知领域的变化是否对 AD 相关生物标志物敏感。
临床正常的 56-93 岁成年人及其知情人完成了日常生活认知量表（ECog）的记忆、分散注意力和视空间能力（评估空间导航）的亚部分。使用 Cronbach's alpha 和验证性因子分析来检查这些亚部分的可靠性和有效性。逻辑回归用于检查 ECog 亚部分预测 AD 相关生物标志物（脑脊液（CSF）ptau/Aβ 比值（=371）或海马体积（=313））的能力。分层逻辑回归用于检查如果有抑郁症状（=197），自我报告的亚部分是否在控制抑郁症状后继续预测生物标志物。此外，逻辑回归用于检查与亚部分评估相同或相似认知领域的神经心理学综合测试（记忆、执行功能和视空间能力）预测生物标志物的能力，以比较主观和客观测量的预测能力。
所有亚部分均表现出适当的可靠性和有效性。自我报告的记忆（去除异常值）是 AD 生物标志物阳性的唯一显著预测因子（即 CSF ptau/Aβ 比值；=0.018），但在有抑郁症状的亚样本中不显著（=0.517）。当将客观记忆综合纳入模型时，自我报告的记忆（去除异常值）是 CSF ptau/Aβ 比值生物标志物阳性的显著预测因子。
ECog 亚部分不是 AD 生物标志物阳性的有力预测因子。
